This is a phase I/II study which intends to characterize the safety, tolerability, and preliminary efficacy of Allogeneic Magicell-NK infusion in PDA or cholangiocarcinoma patients after surgery. Subjects will receive a total of 6 intravenous (IV) infusions of the IP on the 11th day of each chemotherapy cycle. A total of 6 cycles of IP infusions are planned. The phase I part of the study is a first-in-human phase I trial of Allogeneic Magicell-NK and is therefore designed in an open-label, dose-escalation manner. A standard 3+3 design will be employed to assess the safety profile of Allogeneic Magicell-NK and to determine the MTD/MFD. Two dose cohorts are planned: the starting dose is 10 × 10\^8 cells (Cohort 1), and escalates to 20 × 10\^8 cells (Cohort 2). The phase II part of the study is designed as an open-label, two-arm, randomized clinical trial comparing the combination of SLOG and Allogeneic Magicell-NK with SLOG alone when used as adjuvant therapy following resection for PDA or Cholangiocarcinoma. Approximately 30 subjects will be randomized at a 2:1 ratio between the two arms: Arm 1: SLOG and Allogeneic Magicell-NK (20 subjects); Arm 2: SLOG alone (10 subjects). Subjects will then receive 12 weeks of SLOG chemotherapy with or without Allogeneic Magicell-NK infusion.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
42
Drug: SLOG chemotherapy S-1, leucovorin, oxaliplatin, and gemcitabine (SLOG) Biological: Allogeneic Magicell-NK contains NK cells suspended in 100 mL of normal saline Ph I dose starts at 10 × 10\^8 cells (Cohort 1) and escalates to 20 × 10\^8 cells (Cohort 2). Ph II dose will be determined lower than or equal to Ph I MTD/MFD.
Drug: SLOG chemotherapy S-1, leucovorin, oxaliplatin, and gemcitabine (SLOG)
National Cheng Kung University Hospital
Tainan, Taiwan
RECRUITINGPh I Evaluation of safety parameters, numbers of participants with Treatment-Emergent Adverse Events (TEAEs).
The number of participants with Treatment-Emergent Adverse Events (TEAEs) was assessed using the Common Terminology Criteria for Adverse Events (CTCAE v5.0) to assess the tolerability of Magicell-NK treatment.
Time frame: 15 months
Ph I Laboratory tests
Number of participants with abnormal laboratory test results.
Time frame: 15 months
Ph I Body weight
Body weight (KG) will be measured at baseline, treatment, and F1 visits. The number of participants with abnormal body weight change.
Time frame: 5 months
Ph I Vital signs
Number of participants with abnormal vital signs.
Time frame: 15 months
Ph I Dose-limiting toxicities
Adverse events were assessed according to NCI-CTCAE v5.0 criteria.
Time frame: 4 months
Ph I Maximum Tolerated Dose (MTD) and Recommended Phase II Dose
MTD is defined as the highest dose level at which ≤ 1/6 of subjects experienced DLT.
Time frame: 4 months
Ph II Disease-free survival (DFS)
The time from the date of the first Magicell-NK infusion to the date of the first disease-free survival event (recurrence, second primary PDA or Cholangiocarcinoma, or death from any cause).
Time frame: 15 months
Ph I Disease-free survival (DFS)
The time from the date of the first Magicell-NK infusion to the date of the first disease-free survival event (recurrence, second primary PDA or Cholangiocarcinoma, or death from any cause)
Time frame: 15 months
Ph II Evaluation of safety parameters, numbers of participants with Treatment-Emergent Adverse Events (TEAEs)
The number of participants with Treatment-Emergent Adverse Events (TEAEs) was assessed using the Common Terminology Criteria for Adverse Events (CTCAE v5.0) to assess the tolerability of Magicell-NK treatment.
Time frame: 15 months
Ph II Laboratory tests
Number of participants with abnormal laboratory test results.
Time frame: 15 months
Ph II Body weight
Body weight (KG) will be measured at baseline, treatment, and F1 visits. The number of participants with abnormal body weight change.
Time frame: 5 months
Ph II Vital signs
Number of participants with abnormal vital signs.
Time frame: 15 months
Ph I/II Tumor recurrence rate (TRR)
To evaluate the Tumor recurrence rate (TRR) during the study period
Time frame: 15 months
Ph I/II Changes in Frequency and Duration of ctDNA
Number of participants experiencing ctDNA seroconversion (i.e. ctDNA+ that become ctDNA-) after any Allogeneic Magicell-NK regimen remaining disease free
Time frame: Up to 15 months
Ph I/II Changes in Frequency and Duration of Circulating Tumor Count (CTC)
Determine the effect of Allogeneic Magicell-NK on reducing CTC of whole blood in the subject with elevated baseline CTC count to identify the least effective dose that clears CTCs. The baseline count of CTC will be recorded before Allogeneic Magicell-NK therapy in a whole blood sample. In the treatment, the count of CTC will be measured at C4D1 and each follow-up visit after Allogeneic Magicell-NK therapy in a whole blood sample. All of these values will be compared.
Time frame: Up to 15 months
Ph I/II Changes in Biomarkers (CA19-9 and CEA)
Determine the effect of Allogeneic Magicell-NK on CEA and CA 19-9 in the subject with elevated baseline CEA and CA 19-9 to identify the least effective dose that clears CEA and CA 19-9. The baseline count of CEA and CA 19-9 will be recorded before Allogeneic Magicell-NK therapy. In the treatment, the count of CEA and CA 19-9 will be measured at C4D1. And each follow-up visit after Allogeneic Magicell-NK therapy. All of these values will be compared.
Time frame: Up to 15 months
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